| Generic and therapeutic substitutions in the UK: are they a good thing? | |
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MedLine Citation:
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PMID: 20716231 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is considerable interest and debate concerning the place of generic substitution (switching from a brand to generic product); and on therapeutic substitution, that is, switching to a cheaper, but apparently equivalent, product, usually within the drug class. Generic substitution by pharmacists is standard practice in UK hospital settings, and is being proposed for implementation in primary care. Although most prescriptions are already written generically (83% in the community in England in 2008), there are still cost savings that could be made if generic medicines are substituted against prescriptions written by branded name or by getting prescribers to adhere to advice to prescribe generically. Therapeutic substitution is more contentious, as direct evidence to support equivalence is normally lacking. However, the price differential between established drugs whose patents have expired and for which generics are available and newer, branded medicines within the same therapeutic class, makes therapeutic substitution an attractive application of cost-minimization analysis for the more efficient use of healthcare resources. Here we explore the tension that exists between the clinical appropriateness and safety of switching from an individual patient perspective and the consideration of value for money which is required to maximize population health from a health service perspective. Although substitution may affect individual patients (such as, for instance, reduced adherence, increased potential for medication error), it might be a price worth paying given the opportunity cost associated with the use of medicines that are clinically no better than cheaper alternatives. |
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Authors:
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Martin G Duerden; Dyfrig A Hughes |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: British journal of clinical pharmacology Volume: 70 ISSN: 1365-2125 ISO Abbreviation: Br J Clin Pharmacol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-18 Completed Date: 2011-02-03 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 7503323 Medline TA: Br J Clin Pharmacol Country: England |
Other Details:
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Languages: eng Pagination: 335-41 Citation Subset: IM |
Affiliation:
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Betsi Cadwaladr University Health Board, Cardiff University, Princes Park, Princes Drive, Colwyn Bay, Conwy, North Wales, LL29 8 PL, UK. Martin.Duerden@wales.nhs.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cost-Benefit Analysis Drug Utilization / economics* Drugs, Generic / economics* Great Britain Humans Patient Satisfaction / economics Physician's Practice Patterns / economics Therapeutic Equivalency Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Drugs, Generic |
| Comments/Corrections | |
Comment In:
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Br J Clin Pharmacol. 2011 Jun;71(6):966-7; author reply 968
[PMID:
21504441
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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